BP-666 CT
BUILDING PERMIT %
FIELD INSPECTION
Dartmouth Building Department Plat : 066
400 Slocum Road-P. O. Box 9399 Lot (s ) : 71
North Dartmouth, MA 02747 Lot Size :
Telephone 508-999-0720 Zone Dist. : sra
Issued Date : 06/10/92 Permit No. : 666
Project Location : 1233 Reed Road
Ndmtrar Street
Subdivision Name :
Nearest Cross Street : North Hixville & Route 195
•
Applicant/Agent : Manuel L. Leite
Contact Person Phone #: t ) 508-995-2855
Proposed Use : _ Residential
Residential. Commercial. Industrial, etc. —'�—
Permit Issued To : Install
Type of ladrovement. Add. Alter. N... tenet., Demo. Lend/move. etc.
48' Tower
indicate no. of bedrooms and bathrooms and other rooms
Owners) of Record : Manuel L. Leite
Address 1233 Reed Road, North Dartmouth, Me 02747
I RIL T :ML' TY€> O . . . . ...... .. ON R j4Rat 5 IN T T I RL. : I
BUILDING PERMIT
Dartmouth Building Department Plat : 66
400 Slocum Road—P. O. Box 9399 Lot (s) : 71
North Dartmouth, MA 02747 Lot Size:
Telephone 508-999-0720 Zoning Dist. : SRA
June 9, 1992 (typed) Permit No. : 666
Issued Date: 06 / 10/ 92 Clerk: lls
Project Location: 1233 Reed Road
Number Street
Subdivision Name:
Nearest Cross Street :
Applicant/Agent : Manuel L. Leite .
Address : 1233 Reed Road. North Dartmouth, MA 02747
Contact Person Phone #: ( ) 508-995-2855
Type of License: Owner: (x) Const. Superv. License #: (
Architect : ( ) Engineer: ( ) Other: (
( Proposed Use: Residential
Residential, Caaaerelal, Industrisl, eta.
Permit Issued To: Install
Type of Isar ovoeRt. Add, Alter, New Cent., Deee, Lead#Move, ete.
48' Tower
-sonatr.noret:beareeas-end-aetnraums-aoG-atber-_
Gross Area of Const. : Cost of Const. $ 100. 00
Cost—Other Const. : TOTAL FEE: $ 30. 00
IOwner (s) of Record : Manuel L. Leite
Address: 1233 Reed Road, North Dartmouth. MA 02747
All work shall comply with 780 CMR 5th Ed. (MGL Chap. 142) and any
other applicable Mass. Laws or codes and plans on file.
I hereby certify that the proposed work is authorized by the owner
of record and I have been authorized by the owner to make this
application as his authorized agent.
Signature of Owner/Agent : ;. Pia i
Address:
********************************************** rota******************
Signature : Q r� � •-.
Approved/Issued By: avid J. Silveira, Building Commissioner
COMME TS: MANUFACTURED TOWER ADJACENT TO HOUSE FOR NON—COMMERCIAL USE
ORIGINAL 0 APPLICANT 0 ASSESSORS 0 CLERK 0 COPY
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�" PERMIT NO. . (O
ilsf;T<2,' ` 13 % TOWN OF DARTMOUTH DATE ISSUED U u
I0i I A ''• mi ___
o g�, f TOTAL COST
Vk•1 // :-.vY. �' APPLICATION FOR
��,(�
a\ "?:' LESS APPLICATION FEE r X it
ip. 185�y BUILDING PERMIT FINAL PERMIT FEE
oK NS 4, -9- 92
LOCATION OF BUILDING
? )
01 Number & Streetn
1 �. E'=�� � • 01.1 Zoning District •�P<
C\ 2 Cross Streets(between) / and
J �'3 Lot r Plat 1_p �� 04 Subdivision Lot
OWNERSHIP COST
05 ❑ Private (individual, corporation, 36 Cost of Improvement
non-profit institution, etc.) 36.1 To be installed but not
06 ❑ Public (Federal, State, or local government) included in the above cost
TYPE OF CONSTRUCTION 36.2 Electrical
07 ❑ New Construction 36.3 Plumbing
08 ❑ Addition -Type of Room(s) 36.4 HVAC
09 ❑ Alteration 36.5 Other - Specify
10 ❑ Foundation Only example: elevator 0,-6)
/
11 ❑ Demolition (#of units if residential) 37 TOTAL 17
12 ❑ Moving (relocation) STRUCTURE
STATISTICS 38 ❑ Wood Frame
13 Number of Bedrooms 39 ❑ Masonry (wall bearing)
14 Number of Bathrooms (Total) 40 ❑ Structural Steel
Full-Tub 41 ❑ Reinforced concrete
3/4 - Shower 42 ❑ Other - Specify
1/2 - Toilet Only
RESIDENTIAL-PROPOSED USE DIMENSIONS
15 ❑ One-Family 43 Number of stories
16 ❑ Two or more families 44 Total square feet of floor area, all floors,
Number of units based on exterior dimensions
18 ❑ Garage 45 Total land area, square feet
18 ❑ Shed q
19 ❑ Carport
20 ❑ Swimming Pool SEWAGE DISPOSAL
In-Ground Above-Ground
21 ❑ Woodstove 46 ❑ Public or private company
2v„,.Fireplace p 47 ❑ Private (septic tank, etc.)
2Other- Specify 70 (",E H S
6- FE. 7S WATER SUPPLY
48 ❑ Public or private company
NON-RESIDENTIAL - PROPOSED USE 49 ❑ Private, (well, cistern)
24 ❑ Amusement, recreational 25 10 Church, other religious PRINCIPAL TYPE OF HEATING FUEL
26 ❑ Industrial 50 ❑ Gas
27 ❑ Parking Garage 51 ❑ Oil
28 ❑ Service station, Repair garage 52 ❑ Electricity
29 ❑ Hospital, institutional 53 ❑ Coal
30 ❑ Office, bank, professional 54 ❑ Other - Specify
31 ❑ Public utility s
32 ❑ School, library, other educational TYPE OF MECHANICAL
33 ❑ Stores, mercantile 55 Will there be central air conditioning? ❑Yes ❑ N9
34 ❑ Tanks, towers
35 ❑ Other- Specify 0 a't.`RSNb 56 Will there bean elevator? ❑Yes ❑
li PARKING PER ZONING BY-LAWS y
57 0 Enclosed 58 ❑ Outside
Cl
59 Does this building contain asbestos? ❑ YES ❑ NO If yes complete the following:
Name & Address of Asbestos Removal Firm:
IDENTIFICATION - To be completed by all applicants PLEASE PRINTg T (� c� • .,
bi Owner (print) /-(.AA/O ri. L' . LP / 3 3i /C �J P hJ , ,,y Fes. 9 l,` oY C S--6
• NAME AILING ADDRESS TELEPHONE NO.
ZlV 7 /Zs
61 Signature DATE
Builder's
62 Contractor (print) License No.
NAME MAILING ADDRESS TELEPHONE NO.
63 Signature DATE
64 Architect or Engineer (print)
NAME MAILING ADDRESS TELEPHONE NO.
65 Signature DATE
CERTIFICATION TO PERFORM WORK
66 I/We hereby appoint
NAME ADDRESS
as my/our agent for the purpose of applying for and obtaining a building permit for the work to be done described in this
application.
Signature DATE
ADDITIONAL INFORMATION
67 Has A-1 or Determination been issued by Conservation Commission? ❑ YES ❑ NO
Submit copy of notification sent to DEQE and the State Dept. of Labor Industries and result of air sample analysis after
asbestos removal is complete.
pcOwner or Agent - I certify under peril of the enalties of perjury that the information herein is accurate to the best of
my knowledge. _
Signature c/i/le, .,Q _-wt DATE
Own Agent
69 BOARD OF HEALTH REVIEW DATE
Inspector or Authorized Person
COMMENTS:
70 DPW- WATER Service No. SEWER Service No.
To be completed upon issuance of permit- (if applicable)
/ J� 71 I will post permit ag�IJJldress so as to It, isib frro street.
\ Signature /• 1U71-t -/ C —G! DATE
I have received list p required inspections
Signature DATE
Own or ent'
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